According to a recent Rutgers study, women are more likely to die within five years of elective surgery to repair a weakened aortic wall or to need repeat surgery.

Write in the Journal of Vascular Surgerythe Rutgers researchers said the disparity between men and women who undergo the surgery needs to be addressed by including women in early detection of aortic aneurysm as well as incorporating more women in clinical trials of medical devices aortics.

“Despite the fact that men are more likely to be diagnosed with and die of an abdominal aortic aneurysm [AAA], women are still underrepresented in many clinical trials of aortic devices used in the minimally invasive repair of aortic aneurysms,” said William Beckerman, who led the study and is an assistant professor in the Division of Vascular Surgery. and Endovascular Therapy at Rutgers Robert Wood Johnson School of Medicine. “As men and women are known to have different aortic anatomy, this study highlights the need to focus more on including women in the creation of aortic devices and enrolling in subsequent trials.”

An abdominal aortic aneurysm, a condition that led to the death of Albert Einstein in 1955, is life-threatening and common among older people. Such aneurysms occur when the abdominal aorta – the main blood vessel that supplies blood to the stomach, pelvis and legs – swells, then ruptures and eventually causes hemorrhaging.

The treatment, a surgery known as endovascular abdominal aortic aneurysm repair (EVAR), focuses on treating the problem early by inserting fabric-covered metal scaffolds into a person’s damaged aortic vessel. to surround the weak point before it swells and bursts.

Aortic aneurysms or aortic dissections caused 9,904 deaths in 2019, according to the US Centers for Disease Control and Prevention.

Researchers conducted a retrospective chart review of 273 patients – 75% male and 25% female – who underwent EVAR from 2011 to 2020 at a tertiary medical center, a facility serving patients receiving highly specialized medical care. . The idea was to find out how many patients survived five years after surgery and how many needed repeat surgeries. Women were on average older than men and were more likely to have chronic obstructive pulmonary disease, need home oxygen therapy or dialysis.

Despite some variation in morbidities, the differences in survival and repeat surgery were statistically significant, the researchers found. Women had significantly lower survival rates at five years as well as a higher rate of reoperation during those years.

“Our question was, knowing all these things we do, do men and women have different outcomes – even if they’re operated on by the same surgeon, in the same hospital with the same devices?” says Beckerman. “The answer to that was ‘yes.’ Men and women do differently after surgery.

“Our data suggest that factors beyond patient age and baseline health risk likely contribute to greater surgical morbidity and mortality in women after elective EVAR,” Beckerman said.

Other Rutgers researchers on the study were Division Chief Saum Rahimi, as well as Robert Wood Johnson Medical School students Taylor Corsi, Michael Ciaramella, Nadia Palte and John Carlson.


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